Pulling off a multimillion dollar renovation of a restaurant while it is still in operation is a feat in and of itself, but to accomplish this with no cooking equipment, only 50 seats to serve 5,000 customers daily and with only a 15 percent drop in sales seems unheard of.

By relocating the coffee service inside the store from a coffee cart in one of the dining rooms, gross sales increased dramatically at Moffitt Café at the University of California San Francisco Medical Center.

Despite great challenges, Dan Henroid, director of the Department of Nutrition and Food Services at the University of California San Francisco Medical Center (UCSF), and his team were able to design an overall plan to work through these challenges, while also meeting California's strict hospital building seismic codes.

The main portion of the 400-seat Moffitt Café, along with the Moffitt Café Express convenience store, was completed in just nine months. Even more impressive, the café renovation resulted in a 20 percent increase in sales.

Located in San Francisco, UCSF, including UCSF Medical Center, is the second largest employer in the city with a staff of 22,000 people. Henroid oversees patient foodservice at two hospitals, inpatient and outpatient nutrition services, and five retail foodservice operations in addition to a catering program that handles 10,500 events annually.

With the retail operations facing direct competition from six quick-service restaurants across the street, including a couple of well-known chains, Henroid convinced the hospital administrators to invest the necessary resources to improve UCSF's foodservice program.

After making his first plea for the renovation in December 2006, initial capital for the project was provided the following June. Although the budget for the project was steep, $6.5 million, Henroid hesitates to reveal the project's cost. "I know it's easy to renovate a couple of cafes in other parts of the country for this amount, but the state of California regulations and seismic guidelines dramatically increased our costs," he says.

The renovation's goal was to not only renovate the cafeteria, but also modernize the operations. Henroid and his team wanted the décor and menu to better represent the region. "This project gave us the opportunity to be more innovative from a culinary standpoint, but also create a place of reprieve where people forget they are in a hospital," he says.

Despite the serving area shutting down from January until October of last year, and the dining room restricted to 50 seats for fire code reasons, there were no service disruptions during this project. The renovation was completed in two phases. Phase One dealt with the creation of the Moffitt Café Express convenience store, which is immediately adjacent to the Moffitt Café. Built out of the café's former trash room, this store almost doubled the 345 sq.-ft. space to 545 sq. ft. "I knew when I came to UCSF and interviewed for my position that this room had potential," Henroid says. "It was in a prime location right off the main elevator lobby with windows on one side to bring natural light into the space."

By relocating the coffee service inside the store from a coffee cart in one of the dining rooms, its gross sales immediately increased from $600,000 to $1.3 million annually. The store also provides grab and go food, bottled beverages, pastries, and made-to-order sandwiches.

After the store renovation was completed, the team went to work converting the smaller of the hospital's two dining rooms into a servery. With a comfort food station plus carving and Panini stations at lunch, the UCSF team developed a dramatic grab-and-go program to facilitate sales and move people out of the small serving area.

From this cramped situation, the UCSF team added three new food stations to the serving area including pizza, a deli with made-to-order sandwiches and Paninis, an action station adjacent to the existing grill and comfort food stations. The action station, called the Chef's Table, is located between the grill and entrée areas, which replaced the former dessert station. This has a rotating food theme and also brings in guest chefs from local restaurants to create their specialties.

"Before the renovation, there was limited hot food in the servery," Henroid says. "Now we have added versatile and modular equipment. For example, the sauté range at the Chef's Table can be used for omelets in the morning, then disconnected and replaced with a wok in the afternoon."

A nearby steam table is employed during busy periods, when it's not always possible to provide made-to-order dishes. This is converted into a cold well in the afternoon to hold ingredients for stir fry, burritos and other wok dishes.

These changes not only shortened wait times for customers, but also increased the restaurant's center-of-the-plate options.

One of the biggest transformations was the pizza program. Prior to the renovation, UCSF purchased pizza par baked from a pizzeria down the street and staff finished it off at the restaurant. Now, with the new wood-burning oven, pizza is made from scratch and sales are up 300 percent. "We charge a flat price for our pizza, $3.50 per slice with unlimited toppings, which makes it easier to ring up and offers customers value," Henroid says.

Value pricing also was implemented into the salad bar program. The former salad bar was very large and the price was determined by weight. Now, although there are fewer options, customers can include a variety of value ingredients in a small box for $3.50 or a larger $6 box. Changing the structure and payment method has made the salad bar the second highest grossing station after the grill.

There were big changes in the equipment lineup, as well. Before the renovation, a grill was the only cooking equipment utilized. "Not only did we make the grill bigger and better, we took the 48-inch flat top off the back wall and installed a 60-inch unit out front," Henroid says. This change has staff facing customers while cooking, which has improved customer service. Now, backs are turned only when the fryer or char broiler are being used.

A hot display case for grab and go items was added by the grill, and two islands with cold wells replaced a steam table with comfort food in the middle of the café. With equipment, including a steamer, fryer, convection oven and work table behind the entrée station, efficiencies have increased. "If vegetables need to be steamed off, we no longer need to run back to the main kitchen," Henroid says.

A hood system was built to accommodate this added equipment, and a built-in pass thru stacked warmer provides additional holding capabilities.

A 15,000 sq.-ft., 1950s era central kitchen is adjacent to the servery and includes four steam jacketed kettles, two stack steamers, a wok, two fryers, two convection ovens, 36- and 48-inch flat tops, a salamander and walk-in refrigerators and freezers. "We were hoping to spend money to update the central kitchen, but we didn't come close to having the resources for this," Henroid says. "This required state approval for a massive renovation under the hood to get the duct work up to code, and we would have had to take hospital rooms out of commission for this project." Fortunately, the renovations created a more self-supporting café, so the central kitchen is relegated for bulk items, such as soups and chili.

The team was able to create a custom room service work center within the central kitchen to support UCSF's children's hospital, which added the service in April 2010 and will be expanded to the oncology unit within the next year. This area, which is 30 ft. away from the cooking line, creates about 140 trays daily.

"We had a long series of work tables on a slab foundation with utilities built in, so we cut and capped all the utilities and dropped this custom-made work center on top," Henroid says. Efficiencies also were increased in the café. Rather than having the cashiers at opposite ends of the restaurant, there are now six side-by-side checkout lanes. This facilitates quicker payment and allows customers to more easily choose the shortest line. A cashless payment system also was instituted. Now employees can pay for their meals with their UCSF ID badges and save 10 percent on their bill in the process.

Speed of service also has been enhanced with a new point of sale system configuration. Only a handful of items are keyed in, with the bulk of food bar coded for quick scanning in addition to using commercial bar codes for things like bottled beverages.

"The combination of the cashless payment system and bar coding, in addition to a more efficient, streamlined design, have helped people get in and out of the restaurant quicker," Henroid says. A new online ordering system that allows customers to preorder and prepay for their food has also expedited service.

Although the larger dining room's seating shrunk from 400 to 366 seats to make room for the cashier lanes, the occupancy rate has increased from 40 to 60 percent during peak meal times. Adding the convenience store and relocating the vending room adjacent to the 162-seat dining room has allowed the restaurant to close two hours earlier and reduce operating expenses by about five percent. When the café is closed, the store remains open.

With the increases in sales, profits, speed of service and efficiencies, UCSF's renovation is expected to recoup investment costs sooner rather than later. "We expect to be doing $6 million in overall retail sales and $2.2 million in catering on top of that amount," Henroid says.